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General NPI Number Information
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NPI Number | 1740051879
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Entity Type | Organization
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Legal Business Name | SAGE THERAPY SERVICES LLC
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Dates
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Enumeration Date | 01/09/2024
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 22 N BROAD ST FL 2
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City | WOODBURY
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State | NJ
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Zip | 08096-4603
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Country | US
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Telephone | 856-436-0035
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Fax | 833-740-4280
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Provider Business Mailing Address
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Address Line | 22 N BROAD ST FL 2
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City | WOODBURY
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State | NJ
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Zip | 08096-4603
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Country | US
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Telephone | 856-436-0035
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Fax | 833-740-4280
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Authorized Official
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Title or Position | COO
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Name | SHARONDA BEVERLY
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Credential |
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Telephone | 856-436-0035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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